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Botulinum toxin: A review of the mode of action in migraine
Author(s) -
Do T. P.,
Hvedstrup J.,
Schytz H. W.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12906
Subject(s) - migraine , botulinum toxin , chronic migraine , neurology , medicine , mode of action , migraine treatment , neuroscience , dystonia , pharmacology , anesthesia , psychology , biology , biochemistry
Botulinum toxin serotype A (Bo NT /A) was originally used in neurology for the treatment of dystonia and blepharospasms, but is now clinically used worldwide for the treatment of chronic migraine. Still, the possible mode of action of Bo NT /A in migraine is not fully known. However, the mode of action of Bo NT /A has been investigated in experimental pain as well as migraine models, which may elucidate the underlying mechanisms in migraine. The aim of this study was to review studies on the possible mode of action of Bo NT /A in relation to chronic migraine treatment. Observations suggest that the mode of action of Bo NT /A may not be limited to the injection site, but also includes anatomically connected sites due to axonal transport. The mechanisms behind the effect of Bo NT /A in chronic migraine may also include modulation of neurotransmitter release, changes in surface expression of receptors and cytokines as well as enhancement of opioidergic transmission. Clinical and experimental studies with botulinum toxin in the last decade have advanced our understanding of headache and other pain states. More research into botulinum toxin as treatment for headache is warranted as it can be an attractive alternative for patients who do not respond positively to other drugs.